End Of Life

MISHAWAKA -- Saint Joseph Regional Medical Center will host free one-hour community forums about advance directives and planning for end-of-life care at noon and 6 p.m. Sept. 6 in Rooms D and E of its Education Center. Featured speakers include Dr. James Foster, the hospital's ethics consultant and director of the Center for Health Sciences Advising at the University of Notre Dame; and Jason Schultz, the hospital's general counsel who oversees legal issues, compliance and patient privacy and security.

Please don't laugh too hard at me. For the past two months, I've been on hospice duty for a cat. Bert is 20 years old. We don't know whether it's arthritis or senility, but in June she stopped taking care of her hindquarters, and her fur back there is all matted down. Sometimes, she can't remember where her litter box is. So, we get surprises on rugs, or on the wood floor next to the fireplace. The volume on her meows has gone up proportionally to the loss of her hearing. So, she's louder and comes off sounding very grumpy when it's feeding time.

SOUTH BEND -- Who will make health care decisions for you if you can't make them yourself? Who will speak for you and tell doctors your wishes for end-of-life care? Would you want all resuscitation measures taken in the event your heart stopped or you stopped breathing? Family practice physician Dr. Maureen Ziboh, medical director at West Bend Nursing and Rehabilitation, will lead a discussion about planning for end-of-life health care. It is set for 6:30 p.m. Wednesday at West Bend Nursing and Rehabilitation, 4600 W. Washington St. It is open to the public.

A living will or advance directive could have saved Terri Schiavo's family from the long legal battle that ended with her death in 2005. The document is a simple form that can easily be filled out and placed on file at any hospital. You just ask for the form at the hospital's information desk. But it isn't ironclad. There's always a chance that the living will could be legally challenged by friends or family. Besides, when you're filling out the form, it's hard to imagine and think of a response to every medical situation you could end up in, says Cathleen Kaveny, who teaches in the University of Notre Dame Law School and holds a doctorate in theology.

FORT LAUDERDALE, Fla. -- Those on both sides of the contentious right-to-die debate agree there was one bright spot in the tragic events surrounding Terri Schiavo's death one year ago last Friday: It prompted thousands to draft living wills detailing the care they would want if they could not speak for themselves. But some experts now say living wills, for years touted as the way for patients to retain control and avoid painful end-of-life family feuds, on their own offer little protection.

WASHINGTON -- Gerontologists and other health professionals who work with those facing death say end-of-life conversations generally are valuable to both the patient and family. Here are some tips they offer to patients and their relatives: -It's up to you whether your talk concerns just practical affairs or deeper emotions. The conversation can range from whether a dying parent wants a feeding tube or ventilator to the music he wants played at his funeral. -There are several ways to broach the topic.

A recent Tribune story about the general reluctance to talk about or consider hospice care triggered memories of the "death panel" furor that erupted several summers ago. During the heated debate over the health care bill that became the Patient Protection and Affordable Care Act, a provision that paid doctors for an advance care planning consultation with Medicare patients touched a nerve. Intended to give patients a chance to consider end-of-life care options and make their wishes known while they were able to, this concept, through distortion and fearmongering, became something sinister.

SOUTH BEND -- Who will make health care decisions for you if you can't make them yourself? Who will speak for you and tell doctors your wishes for end-of-life care? Would you want all resuscitation measures taken in the event your heart stopped or you stopped breathing? Family practice physician Dr. Maureen Ziboh, medical director at West Bend Nursing and Rehabilitation, will lead a discussion about planning for end-of-life health care. It is set for 6:30 p.m. Wednesday at West Bend Nursing and Rehabilitation, 4600 W. Washington St. It is open to the public.

With the remarkable improvements in technologies and medical care, we have the ability to artificially prolong life for those at the end of life. In many circumstances, that can be wonderful and desirable, but not always. The current traditional advance-directives legal documents -- living wills and medical (or durable) powers of attorney -- give end-of-life patients the ability to retain control over their medical care; they can document their general philosophies, values and choices regarding their care, and potential extraordinary measures that should or should not be employed.

Americans need to change the way they think about death and dying. The United States spends about $70 billion a year -- one-third of all Medicare expenditures -- on medical care for the elderly in the last months of their lives. If money for health care is going to be limited, and we know it is, then we need to think and talk about whether this is the right place to be spending so much of it. The Republican candidates for president all are promising to repeal President Barack Obama's health-care reforms, which may or may not sit well with people already benefiting from health insurance because of them.

MISHAWAKA -- Saint Joseph Regional Medical Center will host free one-hour community forums about advance directives and planning for end-of-life care at noon and 6 p.m. Sept. 6 in Rooms D and E of its Education Center. Featured speakers include Dr. James Foster, the hospital's ethics consultant and director of the Center for Health Sciences Advising at the University of Notre Dame; and Jason Schultz, the hospital's general counsel who oversees legal issues, compliance and patient privacy and security.

April 16 was National Healthcare Decisions Day, an initiative to encourage people to express their wishes regarding their healthcare through advanced directives. Advance Directives are legal documents that state your decisions regarding medical treatment at the end of life, should you be unable to make the decision yourself. It is critical to share your decisions regarding end-of-life care, appoint a healthcare power of attorney, and address financial issues such as wills and paying for long-term care in advance.

HEALTH MATTERS DR. PAUL DONOHUE Q. Why do I get frequent fever blisters in my mouth? They last for days and then go. Does this have anything to do with irritable bowel syndrome, or nutrition or lack of nutrition? A. Fever blisters are also called cold sores. They're caused by the herpes virus type 1, HSV-1. Almost 80 percent of adults are hosts to HSV-1, and, of that number, up to 40 percent have recurrent outbreaks. The virus stays with people for life. A fever blister usually occurs at the bottom and side of the lower lip. At first it is a number of small blisters on a red base that eventually form a golden crust.

EVENTS Bell dedication planned Sunday VANDALIA -- Penn Township officials would like to invite the public to celebrate John K. Gore's years of service as the former township supervisor. A dedication of the bell at the Penn Township Hall, 60717 S. Main St., Vandalia, will be at 2 p.m. Sunday. The bell was originally dedicated to Nellie O'Dell in 1975. The 1975 dedication was to recognize O'Dell for her 38 years of teaching at the Vandalia School. The Vandalia School operated from 1873-1971.